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 Table of Contents  
ORIGINAL RESEARCH
Year : 2022  |  Volume : 13  |  Issue : 1  |  Page : 10-15

The Effect of Application of Sonic Vibration on the Bond Strength of Glass Fiber Post to Root Dentin using Duo-link and Theracem cements: An In Vitro Study


1 Department of Operative Dentistry, School of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
2 Dental Materials Research Center, Dental Research Institute, Department of Operative Dentistry, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran

Date of Submission31-Aug-2021
Date of Decision10-Dec-2021
Date of Acceptance18-Dec-2021
Date of Web Publication29-Apr-2022

Correspondence Address:
Mohammad Reza Malekipour
Department of Operative Dentistry, School of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Postal Code: 8155139998
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/denthyp.denthyp_122_21

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  Abstract 


Background: This study investigated the impact of sonic vibration on the root dentin-glass fiber post bond strength using two resin cements. Materials and methods: Forty single-canal teeth were randomly divided into four groups (n = 10): Theracem self-adhesive using sonic vibration, Duo-link cement using sonic vibration and abrasion, Theracem self-adhesive, and Duo-link cement. Data were analyzed by one-way analysis of variance, Tukey test, and independent t test (α = 0.05). Results: In the coronal region, the bond strength was not significantly different among the four groups (P = 0.331). In the apical region, the bond strength was significantly higher in the Duo-link cement using sonic vibration than in the Theracem cement using sonic vibration (P = 0.010) and Theracem cement using the conventional method (P = 0.007). Conclusion: Sonic vibration has positively affects the push-out bond strength of glass fiber post to root dentin using Duo-link cement.

Keywords: Endodontically treated teeth, push-out bond strength, resin cement, sonic vibration


How to cite this article:
Hoseini M, Malekipour MR, Shirani F. The Effect of Application of Sonic Vibration on the Bond Strength of Glass Fiber Post to Root Dentin using Duo-link and Theracem cements: An In Vitro Study. Dent Hypotheses 2022;13:10-5

How to cite this URL:
Hoseini M, Malekipour MR, Shirani F. The Effect of Application of Sonic Vibration on the Bond Strength of Glass Fiber Post to Root Dentin using Duo-link and Theracem cements: An In Vitro Study. Dent Hypotheses [serial online] 2022 [cited 2022 May 18];13:10-5. Available from: http://www.dentalhypotheses.com/text.asp?2022/13/1/10/344452




  Introduction Top


Today, the use of glass fiber post has a special priority owing to its dentin-like coefficient of elasticity, the ability to bond to the teeth, the uniform distribution of forces, and beauty in all-ceramic crowns.[1] The most common cause of clinical failure in the reconstruction of endodontically treated teeth is the detachment of glass fiber posts from the dentin.[2] Various factors can affect the bonding strength, including the cement application method, post surface preparation, and storage conditions of the samples.[3] At present, different cements are used to bond the fiber posts to the root canal dentin.[4] Glass fiber posts along with adhesive cements can constitute a mechanically integrated set with dentin. The weakest binding loop in the post cement–dentin complex is the adhesion of cement to the dentin surface.[2]

The bonding strength of cement has a direct effect on the quality of bonding, and the quality of the post cement–dentin bond is the most important factor in the formation of fiber post gear. To reduce technical sensitivity and to avoid debonding, changes have been made in the construction of resin cements and their bonding system.[5]

In the restoration of endodontic teeth, post gear is required when a large part of the crown structure is lost.[6] The use of glass fiber posts as a reliable alternative has a lower root fracture prevalence and an elastic modulus similar to dentin.[7] These posts require an effective root dentin bond. Their long durability is directly associated with the quality of the penetration of resin monomer into the collagen network. However, gear loss has been reported as the most common cause of failure.[7],[8]

The main challenge with fiber posts is to achieve a satisfactory dentinal bond. Various studies have reported post-root debonding as the most common cause of failure.[9] Many attempts have been made to improve the bonding of glass fiber posts to intracanal dentin,[7],[10] but few clinical studies are available.[11],[12]

Ultrasonic is a branch of sound waves concerned with sound vibrations at a frequency range above the audible level. The frequency of oscillating devices in dentistry is sonic at frequencies of 1000 to 6000 Hz and ultrasonic at frequencies of 4000 to 20,000 Hz.[7],[13] Application of the adhesive system using a 170-Hz sonic device improves the bond strength of the adhesive to dentin.[13]

Given the scarcity of studies on the effect of application of sonic vibration and various types of cements on fiber post bond strength in coronal and apical regions, this study examined the effect of two types of resin cements on the push-out bond strength of dentin-glass fiber posts. The null hypothesis of the study was that the type and manner of application of cement would not affect the bond strength of the post to the coronal and apical areas of the root.


  Materials and Methods Top


In this in vitro study, 40 healthy single-canal, full-root human teeth (mandibular premolar and maxillary central) without fracture and dentinal defects were selected and stored in 0.2% thymol solution for 2 weeks at room temperature. The research project was reviewed and approved by the Ethics Committee of the Islamic Azad University of Khorasgan.

For root canal treatment, the coronal part of all teeth was cut 1 mm from the cementoenamel junction (CEJ), perpendicular to the longitudinal axis, using a diamond disk (Spring Health Products, Norristown, Pennsylvania, USA) in a slow-speed handpiece (NSK, Shinagawa City, Tokyo, Japan) under water/air spray. The operating length was determined to be 1 mm shorter than the apex. Dental canals were instrumented with k-flex to file 35 (MANI, Kiyohara Industrial Park, Japan) and then using Gates Glidden drills (MANI). Samples were washed with 0.5% sodium hypochlorite. They were then filled to the CEJ with gutta-percha (Tribest, Yangzhong, China) and AH26 sealer (AH26, Densply Detrey GmbH, Konstanz, Germany) by lateral compaction method. The teeth were then sealed with temporary segment and kept in normal saline at 37°C for 1 week to complete polymerization. Next, the post (Referpost, Angelus, Londria, PR, Brazil) space with a length of 11 mm was prepared using gate nos. 2 and 3 and piezoelectric nos. 2, 3, and 4 (MANI), and the samples were randomly divided into four groups.

Group 1: The Theracem self-adhesive cement (Bisco, Inc., Schaumburg, IL, USA) and sonic vibration (Smile Line, Saint-Imier, Switzerland) were applied. After canal preparation, the post (Bisco, Angelus, Brazil) was cleaned with alcohol, the self-adhesive cement (Theracem) was injected into the canal using the manufacturer’s mixing tip, and the post was placed in the center of the canal and cured (170 Hz) for 2 to 3 seconds. Next, the cement residue was removed, and curing was continued for 20 to 30 seconds.

Group 2: The dual-cure Duo-link cement (Bisco, Inc.) along with sonic vibration and abrasion was applied. After canal preparation, the posts were cleaned with alcohol, and the canal space was etched with 37% phosphoric acid (Pegasus Dental Supplied Ltd, Cheshire, UK) for 15 seconds and then rinsed. The canal space was dried with absorbent paper points (Diadenta Group International, SongDung-DongChongju, Korea). All bond 3 dual-cure adhesives (Bisco, Inc.) were applied to the canal using a micro brush (Smart Dispo, Hebei, China) connected to the sonic vibration device (170 Hz) for 10 seconds, the residues were removed with paper points, and the canal was cured for 10 seconds. Then, the Duo-link cement was mixed according to the manufacturer’s instructions, was applied to the canal, and placed in the center of the canal before curing the post. Next, the post was cured (170 Hz) for 40 seconds.

Group 3: Theracem self-adhesive cement was used without the use of sonic vibration and abrasion and similar to the first group. Group 4: Duo-link total-etch cement was used without the use of sonic vibration and similar to the second group for bonding the post.

For the push-out test, the samples were kept in distilled water at room temperature for 24 hours. Then, they were mounted in transparent resin cylinders to be placed in the cutting machine (Nemo Fanavaran Pars, Mashhad, Iran). After that, the canal space was prepared by making incisions perpendicular to the longitudinal axis of the root to prepare two 1-mm coronal and apical sections [Figure 1] and [Figure 2].
Figure 1 Cutting types in the cutting machine.

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Figure 2 Push-out test.

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Each section in the universal machine (k-21046; Walter + bai, Lohningen, Switzerland) was subjected to a compressive force of 0.5 mm/minute until the post was detached from the root. The bond strength of each section was calculated in Newton.

Before the fracture of samples, the R, r, and h values in the two sections were measured with a digital caliper (Y-100624, Guilin Guanglu measuring instrument Co., China). The area and amount of force for each sample were calculated according to the following formula:



where r is the radius of small post, R is the radius of large post, and h is the post height.

The entrance of the canal and dentin along with the isolated post piece were evaluated under a stereomicroscope (SP10-0224; Motic Instruments Inc, CA, USA) at 40× magnification, and their failure types were classified into three groups [Figure 3]: (1) adhesive failure, (2) cohesive failure, and (3) mixed failure.
Figure 3 Failure types: (a) adhesive failure, (b) mixed failure.

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Data were analyzed by SPSS-22 (IBM Corporation, New York, USA) software using one-way analysis of variance (ANOVA), Tukey test, independent t test, and Chi-squared test. The significance level was set at 0.05.


  Results Top


The mean scores of bond strength obtained from Angelus glass fiber posts to the coronal and apical parts of the root with two types of resin cement, Theracem and Duo-link, using conventional cementing methods, and sonic vibration are presented in [Table 1]. As shown, the highest bond strength was related to the coronal area and Duo-link resin cement by the sonic vibration method, and the lowest bond strength was related to the apical area and Theracem resin cement by the conventional cementing method [Figure 4].
Figure 4 Mean bond strength of Angelus glass fiber posts by conventional and sonic vibration methods using Theracem and Duo-link cements in coronal and apical regions.

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Table 1 Comparison of bond strength between apical and coronal regions with Theracem and Duo-link cements using conventional and sonic vibration methods

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The one-way ANOVA test showed no significant difference in the mean bond strength of the Angelus glass fiber posts among the four groups (P = 0.331). However, this difference was significant in the apical region (P = 0.003). In the apical region, the highest bond strength was related to the Duo-link cement using sonic vibration, indicating a significant difference for the bond strength of Theracem cement using the conventional method (P = 0.007) and sonic vibration method (P = 0.010) [Figure 5], [Table 1].
Figure 5 Mean bond strength with Duo-link cement using conventional and sonic vibration methods in the apical and coronal regions.

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The independent t test showed a statistically significant difference between the apical and coronal bond strengths in almost all groups, and only a significant difference was not observed between coronal and apical regions in the Theracem group using the conventional method (P = 0.056). Yet, this difference was significant at 10% error level [Table 2].
Table 2 Distribution of failure mode after push-out test

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[Table 2] summarizes the distribution of failure modes in the four study groups. The results of the Chi-squared test did not show a significant difference in the distribution of failure mode between the four study groups.


  Discussion Top


The null hypothesis of the study was accepted so that only the use of sonic vibration in dentin-glass fiber post bonding in the apical region using Duo-link cement showed higher bond strength than the Theracem cement using different methods.

The bond strength of fiber post was higher in the coronal area than the apical area in almost all groups. Asmussen and Peutzfeldt[14] reported a possible relationship between the viscosity of the adhesive system and the ability of the monomer to penetrate dentin. They also showed cervical one-third area indicated the highest bond strength, which is in line with the results of other studies and the present study.[13],[15] This could be associated with the higher density of dentinal tubules in the cervical one-third area than the apical region.

Ferrari et al.[16] showed the presence of resin tags in dentinal tubules caused 30% of the total bond strength. Kirsch et al.[17] also showed higher bond strength in the coronal area than in the apical area. The shape of cavity, poor access, visibility in the post space, and difficult humidity control are the main reasons for the failure of these posts.[18]

In this study, both dual-cure resin cements showed a similar behavior in bond strength in the cervical area, whereas this behavior was not similar in the apical region. The use of sonic vibration improved the bond strength. Mena-Serrano et al.[7] and Cuadros-Sanchez et al.[13] also reported the use of sonic vibration improved the bond strength. This difference can be attributed to the active and passive applications of sonic vibration.

Better results of Duo-link cement than the Theracem cement can be related to the difference in the nature of total-etch adhesive compared to the self-etch adhesive. An additional smear layer seems to have been removed well by acid etching, thereby creating better adhesion.

In this study, there was no significant difference between the application and nonapplication of sonic vibration in the corresponding groups. Mushashe et al. reported the use of adhesive with and without sonic vibration did not affect the bond strength; however, it had a negative effect when used for both simultaneously. However, the use of sonic vibration while cementing the post increased the cement flow, although it did not affect the bond strength, which is consistent with the results of the present study.[19]

Zarpellon et al.[20] showed the use of sonic vibration when using universal adhesives did not improve the bond strength or nanoleakage, which is consistent with the results of the present study. However, Mena-Serrano et al.[7] and Cuadros-Sanchez et al.[13] reported the use of sonic vibration improved the bond strength. This difference is due to the active and passive applications of sonic vibration

Asmussen and Peutzfeldt[14] showed a possible relationship between the viscosity of the adhesive system and the ability of the monomer to penetrate dentin. They also reported the highest bond strength for the cervical one-third area, which contradicts other studies,[13],[15] possibly due to the higher density of dentinal tubules in the one-third cervical region than the apical region.

Kirsch et al.[17] showed no evidence for the better application of sonic vibration in self-etch adhesives in the bonding of fiber post to root canal and coronal dentin than the conventional method, which is in contrast to the results of the study by Cuadros-Sanchez et al.[13] This could be due to differences in the self-etch and etch-and-rinse adhesives in terms of composition and bonding mechanism.

The mean bond strength of glass fiber posts to the root dentin was significantly higher in the coronal area than in the apical area, which is consistent with the results of the study of Yoshiyama et al.[21]

A limitation of this study is that it is an in vitro investigation that does not fully replicate oral conditions. In addition, this study presents outcomes limited to single-load test. Thus, further studies should add thermal, load cycling, and water storage aging methods to challenge the adhesive interface.


  Conclusion Top


The use of a sonic vibration device has a positive effect on the push-out bond strength of glass dentin-fiber posts with Duo-link resin cement in the apical area in comparison with the Theracem self-adhesive cement.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]
 
 
    Tables

  [Table 1], [Table 2]



 

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